Sunday, July 24, 2016

Staff Review: Five Days at Memorial

I have vivid memories of being glued to the television watching the devastation brought on by Hurricane Katrina. Though the coverage was thorough, only those who lived in the areas hit by the hurricane can truly know what it was like. Five Days at Memorial by Sheri Fink, the July discussion title for our Adult Book Discussion Group, details the aftermath of Hurricane Katrina at Memorial Medical Center in New Orleans. Fink, an investigative journalist, spent countless hours over the course of 6 years interviewing 500 plus witnesses, doctors, and nurses, re-watching news footage and gathering information for her book. In 2010 she won the Pulitzer Prize for Investigative Reporting for the article about Memorial that sparked the writing of the book.

The first part of the book is all about actions taken before and during the storm. Initially it was overwhelming, the sheer number of people involved made it difficult to keep track of who was doing what, and where. It felt chaotic, frantic, and disjointed. Was that by design? Was it meant to mimic what the staff and patients at Memorial felt? The confusion, the uncertainty, the fear? I found the part leading up to the storm and the following five days engrossing, I had a hard time putting the book down. I had so many emotions and questions.

I felt anger. Anger at the situation and at the decisions made. I felt sorrow. Sorrow for those who didn't make it out of the hospital, their family members, and for those who had to make the tough choices. I felt anxiety, wondering what would happen to the patients, doctors and nurses. I also felt disbelief. Disbelief that it was common practice in the case of hurricanes for the staff to bring their family, pets and 3-days worth of food to the hospital to ride out the storm. Disbelief that there was no plan in place in case the water rose above the ground floor electrical and generators. Memorial Medical Center (formerly known as Southern Baptist Hospital) was 80-years old, that should have been plenty of time to plan for such a disaster. Disbelief and anger at some of the seemingly selfish actions of the hospital staff. Why would you evacuate the sickest patients last? At the end of the 5 days, 45 patients had died at Memorial, and at least 9 had what could possibly be lethal doses of morphine in their bodies. Some of the dead, according to witnesses, had been alive on the morning of the final evacuations. The question had to be asked, were these patients murdered?

The second part of the book is all about the aftermath of the storm and the legal implications of what happened at Memorial during those five days. One doctor and two nurses were arrested on 4-counts of second-degree murder. The case dragged on for over 2 years as evidence was gathered. During that time, New Orleans was facing multiple problems and legal cases stemming from the storm. Police brutality, questionable deaths at hospitals and nursing homes, plus backlash against all levels of government agencies for their actions, or lack thereof, leading up to, and during the storm. Hindsight is 20/20 and after the water receded it was clear that nobody was prepared for the catastrophic flooding. Fingers were being pointed at anyone and everyone.

I will admit the second half of the book had a few high points, but it did drag. I found myself struggling to finish without just skipping to the end. I'm glad I plodded through the slow parts however because in the second half I learned about the actions of some of the doctors and nurses that I found absolutely shocking. Memorial Hospital was connected to another building, a cancer center, that had power for those five days. Why weren't the patients moved to that facility? The staff claimed that there wasn't enough water and everyone was suffering from dehydration, but in the weeks following the storm, investigators found large supplies of bottled water in the hospital. Another hospital, Charity, faced the same conditions, but with a totally different outcome. Fink mentions in the forward of the book that as more time passed, memories changed or became hazy. I believe that the doctors and nurses remembered the events in a way that allowed them to live with their actions. I also kept asking myself why only one doctor and two nurses were arrested and charged. Based on the first half of the book, I would have expected more of the staff members to face charges. How could they claim to not know what was going to happen?

Fink's epilogue talks about other natural disasters after Hurricane Katrina. New Orleans seemed to have learned its lesson, but did other states learn too? When Hurricane Sandy hit, hospitals in New York State and New Jersey were suddenly faced with the same problems. Rising water, failing power and patients that hadn't been evacuated. Hospitals were exempt from the mandatory evacuations because in the face of a disaster, a hospital is a much needed commodity. I do understand the hospitals and hospital staff are essential, but why wouldn't the patients be moved to safer locations? She also talks about the conditions in Haiti after the earthquake in 2010 and how the medical professionals had to make tough decisions based on lack of resources.

Sitting in my air conditioned house, on my comfortable couch, it is easy for me to say "why didn't they do this or that". I tried to ask myself "what would I do?" I've never faced anything like the people of New Orleans, I can't even imagine the conditions or the fear. I honestly don't know what I would have done. I would hope that I would have fought tooth and nail to preserve life. I would hope that I wouldn't have stood passively by while someone else made a decision about a patient I swore I would take care of. I would hope that my will to survive wouldn't keep me from helping others to survive as well. Most of all, I hope I never have to find out.

Fink's goal isn't to point fingers or sway people's opinions. She presents a fairly balanced accounting of conditions at Memorial and the following investigation. I certainly have my own opinions after reading this book. You can probably glean, from my review, what I think happened. This book sparked a very interesting discussion among our book club members about morality and ethics. I believe that is one of the main goals of Five Days at Memorial, to make people think, ask questions, and start a discussion.